Influence of Age on Clinical Presentation, Therapeutic Options, and Outcome in Chinese Patients with Acute Aortic Dissection
Influence of Age on Clinical Presentation, Therapeutic Options, and Outcome in Chinese Patients with Acute Aortic Dissection
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年龄对中国急性主动脉夹层患者临床表现、治疗选择和结果的影响
DOI：
10.1536/ihj.18-532
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发表时间：
2019-11-01
影响因子：
1.5
通讯作者：
Fan, Xiaohan
中科院分区：
文献类型：
--
作者：
Huang, Bi;Chen, Zhaoran;Fan, Xiaohan
既往研究显示，中国急性主动脉夹层（AD）患者比西方国家患者年轻约10岁。然而，缺乏关于中国急性AD患者临床特征和结局的年龄相关差异的研究。2006年至2008年期间，共招募了1,061例AD患者（570例A型AD和491例B型AD）。将本研究中的患者与国际急性主动脉夹层登记中心（IRAD）中的患者的临床特征进行比较。与IRAD患者相比，我们研究中的患者相对年轻，男性较多，马凡氏综合征比例较高，但接受手术干预较少。当按10岁年龄分层时，年轻患者更可能患有A型AD、家族性AD和马凡氏综合征。而老年患者倾向于包括更多的女性和B型AD。随着年龄的增长，无论AD的类型如何，手术干预的比例都逐渐下降。中位随访时间为2.2年。死亡147例，其中A型AD 94例（63.9%），B型AD 53例（36.1%）。长期死亡率随着年龄的增加而增加，尤其是70岁以上的患者。此外，AD的复发率在年轻和老年患者中均较高。结论：与西方AD患者相比，中国AD患者具有明显的特点，年轻和老年患者的长期死亡率和复发率较高，应给予更多的关注。
It has been shown in previous studies that Chinese patients with acute aortic dissection (AD) were approximately 10 years younger than patients from western countries. However, there is a lack of studies concerning the age-related differences in clinical characteristics and outcomes in Chinese patients with acute AD. A total of 1,061 patients with AD (570 type A and 491 type B AD) were enrolled between 2006 and 2008. The clinical characteristics were compared between the patients in our study and those in the International Registry of Acute Aortic Dissection (IRAD). Compared with patients in the IRAD, those in our study were relatively younger, comprised more males, and had a higher proportion of Marfan syndrome but received fewer surgical interventions. When stratified by 10-year age, younger patients were more likely to have type A AD, familial AD, and Marfan syndrome. whereas older patients tended to comprise more females and type B AD. As age increased, the proportion of surgical intervention gradually decreased regardless of the type of AD. During a median follow-up of 2.2 years. 147 patients died, of whom 94 (63.9%) had type A AD and 53 (36.1%) had type B AD. Long-term mortality increased with increasing age, especially in patients above 70 years old. Furthermore, the recurrence rate of AD was higher in both the young and the older patients. In conclusion, compared with western patients with AD, Chinese patients have distinct characteristics and more attention should be paid to the young and older patients because of their high long-term mortality and recurrence rate.